Journal of Advanced Practice Nursing

2017 Brings More Access To Nurse Practitioners, PAs And Telemedicine


By Bruce Japsen

Americans are poised in 2017 to gain even more access to nurse practitioners, physician assistants and health professionals via smartphones, apps and related digital health technology.

Across the country, states led by both Republicans and Democrats have eased scope-of-practice laws to allow easier access to nurse practitioners and physician assistants. And associations for “NPs” and “PAs” are increasing their lobbying to intensify their push in 2017 to serve more patients.

Meanwhile, employers are increasing access to nurse practitioners and other allied health professionals as Americans become more comfortable being treated by primary care givers other than doctors at worksite clinics and retailers like CVS Health CVS +0.96%, Walgreens Boots Alliance, Wal-Mart Stores WMT -1.37%, as well as grocers like Kroger KR -0.30%.

Employee benefits consultancy Mercer says 82% of large employers now include retail clinics in their health plan networks. The increase employer coverage for retail visits in 2017 comes as 2016 ended with the U.S. Department of Veterans Affairs granting veterans direct access to advance practice registered nurses.

The lower cost option isn’t lost on employers, lawmakers and those lobbying for nurse practitioners. “With 4,800 nurse practitioners currently working in VA facilities nationwide , this is a zero-cost, zero-risk solution and a significantly positive step to strengthening care for those who served our nation,” Cindy Cooke, said two weeks ago.

The incoming administration of Donald Trump still has to implement the new VA regulations expanding access to advance practice registered nurses. “We look forward to working with the incoming Trump Administration to ensure full implementation of this rule,” Cooke said.

But it’s not just VA facilities. Bipartisan support for providing direct access is also building across the country in state capitals to change state scope-of-practice laws that often prevent nurse practitioners from providing certain care without a doctor’s supervision. There are now 21 states plus the District of Columbia that already give nurse practitioners full practice authority .

A similar story can be told by physician assistants, which have seen their ability to perform tasks they are educated to do be accepted under state laws and regulations. Most PAs have a two-year master’s degree, often from a program that runs about two years and includes three years of healthcare training.

The shift to care provided by PAs and NPs comes amid a nationwide doctor shortage and the need for more primary care providers, particularly as 20 million Americans have gained health insurance under the Affordable Care Act.

The access issues faced by Americans have created an opening for telemedicine companies like MDLive, American Well and Teladoc. And that is expected to only escalate as more private insurers and employers provide coverage for telemedicine.

Mercer’s analysis shows 59% of large employers offer telemedicine, “up sharply” from 30% in 2015. Mercer’s data counts telemedicine as a “telephonic or video access” to providers intended to be a low-cost alternative to a physician’s office visit, Mercer said.


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Editor-in Chief:
Kirsten Nicole

Editorial Staff:
Kirsten Nicole
Stan Kenyon
Robyn Bowman
Kimberly McNabb
Lisa Gordon
Stephanie Robinson

Kirsten Nicole
Stan Kenyon
Liz Di Bernardo
Cris Lobato
Elisa Howard
Susan Cramer